Annual Report 2014

Empowering

communities

for sustainable

development

Agency for Assistance and Development of Afghanistan

+93 (0) 785 285 530+93 (0) 700 299 369aaini@aada.org.af

www.aada.org.af

Agency for Assistance and Development of Afghanistan

A word from our Founder

Dear friends;

At the outset, I would like to thank our funders, partners and volunteers for their uns�n�ng support in our mission “A Center of Excellence commi�ed to improving the lives of vulnerable popula�on and community development”

The year 2014 was one of the growth coupled with consolida�on. Our annual budget was closed at over USD 20 million and we directly impacted over four millions beneficiaries.

This year had many achievements for AADA, but I would like to share some key highlights which we believe have had significant impact on our beneficiaries and society at large.

Two new provinces with a total popula�on of 1,917,783 added to our exis�ng Maternal and Newborn Health Programs. The capacity of AADA for provision of EmOC services especially Caesarian Sec�on expanded to Samangan and Nangarhar provinces.

Community Midwifery Educa�on Schools expanded in two new provinces. AADA build partnership with Ghazanfar Ins�tute of Public Health to provide support to Midwifery sec�on of Ins�tute of Health Science in Mazar-e-Sharif city. A total of 24 students graduated from Mazar-e-Sharif CME program and deployed as midwives in remote districts of Balkh and Jawzjan provinces.

AADA had a significant contribu�on toward reduc�on of child mortality and morbidity in Afghanistan. The marginalized groups such as Injec�ng Drug Users received HIV/preven�on and harm reduc�on services.

Finally, I would like to personally thank every single staff members and volunteers of AADA who have worked selflessly and �relessly to serve the vulnerable communi�es. I would like to thank Board of Trustees of AADA for the con�nuous guidance for smooth running and expansion of our programs.

Sincerely yours;

Dr.Jamalluddin JawaidFounder and advisor to AADAAgency for Assistance and Development of Afghanistan (AADA)Mobile: +93(0)777772500

Email: jjawaid@aada.org.af Afghanistan (AADA)Mobile:+93(0)777772500Email: jjawaid@aada.org.af

Dear colleagues;

It is a pleasure to bring out the Annual Report for the year 2014.This report brings out the aims and features of the programs as well as our achievements and challenges. This year, most of our programs did reasonably well and some could have done be�er. AADA in collabora�on with stakeholders and under stewardship of MOPH had a great role in reduc�on of maternal and child mortality rates through BPHS and other health related projects.

Five new projects added to our exis�ng program. We are happy to say that our funding crossed US$ 21,000,000 this year. We are grateful of AADA funders that they have con�nued to repose their trust in this organiza�on.

Under Basic Package of Health Services (BPHS) programs in 6 provinces, a total of 3,762,583 people were covered and preven�ve and cura�ve services were provided to them. The number of Health facili�es increased from 101 in 2013 to 240 in 2014. Family Health Houses and Mobile Support Teams provided cura�ve and preven�ve services for 248,405 -mostly women and children- clients. HIV preven�on and harm reduc�on provided regular support to more than 700 people who inject drugs”.

I would like to thank all AADA members for their great contribu�on toward achieving the projects goals and objec�ves. Thanks for Government of Afghanistan, Ministry of Public Health, GIHS, USAID, World Bank, European Commission, UNFPA, UNICEF, WHO, Global Fund, Save the Children Interna�onal, The Johanni�er and Cordaid for their technical and financial support to Agency for Assistance and Development of Afghanistan.

Thank you very much for engaging with us.

Dr.Sayed Ashrafuddin AiniGeneral DirectorAgency for Assistance and Development of Afghanistan (AADA)Mobile: +93(0)785285530, +93 (0) 700 299 369Email: aaini@aada.org.afWebsite: www.aada.org.af

A word from our Director

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AADA in Action

Agency for Assistance and Development of Afghanistan (AADA) is a non-poli�cal, non-profit, and independent Afghan organiza�on founded in 2005. It was established with the main and foremost aim of provision of quality health and social services, profession capacity building, and promo�on of equal access of communi�es to developmental and humanitarian services.

AADA's Vision: Communi�es are empowered to achieve sustainable health, peace and prosperity

AADA's Mission is “to serve as a center of excellence commi�ed to improving the lives of vulnerable popula�on and community development” focusing on Afghan communi�es, especially women, children and the other vulnerable groups – youth, IDPs, drug addicts, and ethnic minori�es.

Quality improvement, strengthening financial management systems, gender equity & women empowerment and community development are among the main strategic direc�ons reflected in “AADA Strategic Plan 2011-2015”.

Since its establishment, AADA has maintained a proven track/record of successful implementa�on of health and community development projects in several provinces of Afghanistan. So far AADA has been execu�ng projects in most of provinces of Afghanistan which includes: Kabul, Ghazni, Wardak, Logar, Khost, Pak�a, Pak�ka, Uruzgan, Zabul, Helmand, Nimroz, Herat, Kandahar, Kunduz, Jawzjan, Balkh, Daikundi, Bamyan, Parwan, Panjsher, Kapisa, Nangarhar, Samangan, and Faryab.

AADA is governed by the “Board of Trustees” that was come into existence from establishment of the organiza�on; it governs the organiza�on and provides overall policy direc�on to achieve its aims in the most efficient and effec�ve manner, consistent with the organiza�on's values and approaches, and in line with the Afghan government cons�tu�ons. Supervised by Board of Trustees, the management team of AADA Main Office is responsible for overall management of all AADA projects throughout the country. The management team is consis�ng of General Director, Program Advisor, Program Director; M&E/Program Development Director, Capacity Building Director, Opera�on Director and Finance Director.

Monitoring and Evalua�on/ program Development DirectorateThis directorate come into ac�on in 2014, with the aim to represents the final key link in planning process. In order to achieve its goal, this directorate works on developing and upda�ng M&E system to iden�fy posi�ve and nega�ve devia�ons in implementa�on of projects. Monitoring and Evalua�on Department in AADA is headed by a director and it has 4 monitors at na�onal level and 6 monitors at provincial levels.

M&E team of the main office regularly conducts visits from the provinces and provides reports and ac�on plans following each mission. Furthermore, M&E department developed comprehensive checklists for monitoring of health facili�es as well as monitoring of provincial offices. Monitoring department/Program Development Directorate of AADA has developed M&E guideline, security policy and code of conduct of organiza�on, ac�vity calendar and annual report for AADA at na�onal level.

System of Governance

3 4

No Project/Services Province Start Date End Date Source of funding

1 Provision of BPHS under PCH 07 Ghazni Nov-09 Jun-15 USAID/MoPH

2 Provision of BPHS under PCH 05 Bamyan Nov-09 Jun-15 USAID/MoPH

3 Provision of BPHS under PCH 15 Khost Nov-09 Jun-15 USAID/MoPH

4 Provision of BPHS under PCH 06 Faryab Nov-09 Jun-15 USAID/MoPH

5 Result Based Financing (RBF) Bamyan Oct-10 Mar-15 MoPH/World Bank

6Mirbach Kot 20 beds Maternity

HospitalKabul Nov-11 Oct-14 The Johannitter/BMZ

7

Provision of health services

through 33 Family Health Houses

(FHH)

Faryab Jan-12Dec-15

(Extendable)UNFPA

8Community Midwifery Education

(CME)Balkh Mar-12 Jun-14 The Johannitter/BMZ

9Community Health Nursing

Education (CHNE)Jawzjan May-13 Sep-15 Global Fund

10Community Health Nursing

Education (CHNE)Faryab May-13 Sep-15 Global Fund

11Community Health Nursing

Education (CHNE)Wardak May-13 Sep-15 Global Fund

12Community Health Nursing

Education (CHNE)Logar May-13 Sep-15 Global Fund

13Community Midwifery Education

(CME)Balkh Jan-13 Feb-15 Cordaid

14Community Midwifery Education

(CME)Paktika Apr-14 Aug-16 USAID/MOPH

15Community Midwifery Education

(CME)Ghazni Apr-14 Aug-16 USAID/MOPH

16HIV/AIDS treatment and

prevention Ghazni Oct-13 Dec-15 TFM/Global Fund

17HIV/AIDS treatment and

prevention Kunduz Oct-13 Dec-15 TFM/Global Fund

18

Practice of RDT and ACT for the

diagnosis and treatment of

malaria by CHWs and HF staff/

Bed Net distribution

Nangarhar Jan-14 Sep-15 HNTPO/Global Fund

19Supplementary Feeding Program

(SFP)

Bamyan&Sa

manganApr-14 Mar-15 WFP

20

Scaling-up Malaria Control

Interventions and Strengthening

Health Care System in

Afghanistan

Bamyan &

NangarharJan-14 Dec-14 HNTPO/Global Fund

21 Nangarhar SEHAT project Nangarhar Jan-14 Dec-16 World Bank

22 Samangan SEHAT project Samangan Jan-14 Dec-16 World Bank

Through a competent team at main and provincial offices, AADA has implemented projects as follows:

Basic Package of Health Services (BPHS):

As one of the three strategic objec�ves of the organiza�on “To contribute and support to the achievement of lower maternal, under-five and infant mortality rates as targeted by the government of Afghanistan”, the ul�mate goal of AADA public health services is to contribute to realiza�on of the Afghanistan Na�onal Development Strategy (ANDS) through achievement of the Afghanistan Health and Nutri�on Sector Strategy (HNSS) targets. AADA public health services are designed and implemented in line with the specifica�ons of the Basic Package of Health Services (BPHS) and Essen�al Package of Hospital Services (EPHS) guidelines. AADA implements BPHS through System Enhancement for Health in Transi�on (SEHAT) and Partnership Contracts for Health Services (PCH).

Through SEHAT grant, AADA implements the BPHS in Nangarhar province in eastern and in Samangan province in northern region of the country. These projects are commenced in January 2014 and will be con�nued to the end of 2016.

In Nangarhar province, BPHS is implemented through 4 District Hospitals (DHs), 20 Comprehensive Health Centers (CHCs), 58 Basic Health Centers (BHCs), 16 Sub Health Centers (SHCs), one prison health clinic and 902 Health Posts (HPs).

Health service delivery is performed through 3 DHs, 4 CHCs, 13 BHCs, 18 SHCs, one prison health center and 180 HPs in Samangan province.

Through the PCH grant, AADA implements the Basic Package of Health Services (BPHS) in Bamyan , Ghazni , Faryab and Khost provinces since November 24, 2009.

AADA implements BPHS in Cluster one of Bamyan province including Bamyan, Yakawlang, Kahmard, and Saighan districts. It consists 24 HFs and 213 HPs. Despite several challenges in this remote and almost isolated province, all HFs are fully func�onal. A well-func�oning referral system is in place; DH and CHCs are equipped with ambulances. The HFs and HPs are regularly supervised by relevant AADA supervisors and construc�ve feedback/on the job trainings are given to the staff.

In Ghazni province, AADA implements BPHS under PCH contract in nine districts including four insecure districts i.e. Ajristan, Waghas, Rashidan, and Khogiani, through 39 HFs (1 CHC+, 13 CHCs, 20 BHCs, 4 SHCs and 1 Prison G2 Health Center). Through these HFs and 507 HPs, AADA covers 463,300 popula�ons. All of the health facili�es are fully func�onal and have at least one female health worker.

AADA implements BPHS in 8 districts of Faryab province through partnership agreement signed between AADA and SAF organiza�on, funded by MoPH/USAID. Totally 23 HFs including one DH, 6 CHCs, one CHC+, 9 BHCs, 5 HSC and one CEOCs (integrated in Almar CHC) and 273 HPs, are run by AADA in this province. 100% of the facili�es have at least one female health worker.

In Khost province, AADA works as sub grantee to Health Net-TPO and provides health services through 7 CHCs, 5 BHCs, 3 HSCs and 178 HPs.

Through the PCH grant, AADA manages 101 health facili�es and 1,171 health posts in four men�oned provinces, and through SEHAT grant, the total number of HFs are 138 and the total number of HPs are around 1087 in two provinces of Afghanistan.

Our Projects Our Projects

5 6Opera�on Theater in Sultanpoori CHC+ in Nangarhar Province

Mobile Support Teams and Family Health Houses:

A Family Health House (FHH) is a place where you can find a trained community midwife who can provide basic reproduc�ve health and family planning services for women in their own communi�es on a permanent basis, in safe and culturally acceptable circumstances, with the coopera�on of their home communi�es.

A Family Health House: 1. Ensures provision of essen�al reproduc�ve health services to people leaving in remote areas;2. Increases the number of deliveries a�ended by skilled health care providers;3. Strengthens community partnership and ownership and enhances overall sustainability of the health care

system in remote rural areas;

A typical Family Health House is composed of two rooms and a toilet -one room for the community midwife worker's and another equipped as delivery room. Each Family Health House is staffed with one cer�fied midwife, supported by Community Health Workers (one male and one female), 2-4 Family Health Ac�on Groups and an ac�ve Health Shura.

The community midwife and the community health workers are selected from the community, trained by the Ministry of Public Health (MoPH) with the technical support of the United Na�ons Popula�on Fund (UNFPA), and then deployed to serve the rural communi�es through the Family Health House. By establishing Family Health Houses, the role of Mobile Health Teams (MHTs) changed as Mobile Support Teams (MSTs). The MSTs provides Health Services Delivery in FHHs only. There are three Mobile Support Teams for thirty-three Family Health Houses in Faryab province. MSTs in addi�on to provision of basic health services also technically support and supervise the midwives those are working in Family Health Houses in very remote and isolated communi�es

HIV preven�on ad Harm Reduc�on projects in Kunduz and Ghazni Provinces:

Since October 2013, the HIV preven�on and Harm Reduc�on projects in Kunduz and Ghazni provinces are contracted under the name of Transfer Funding Mechanism with Ministry of Public Health. The Global Fund, financially supports this project through government of Afghanistan.

This project provides services through HIV/STI center, VCCT, Community-based Drop-In Centers, Prison-based centers, Peer-led community outreach services, Support to People Living with HIV/AIDS (PLWHA), and TB/HIV collabora�ve ac�vi�es.

Community Midwifery Educa�on Program (CME-P):

Afghanistan has one of the highest maternal mortality ra�o in the world; most of the maternal deaths are due to the lack of skilled birth a�endants. Lack of skilled birth a�endants has nega�ve impact on the neonatal health and contributes to the high infant mortality as well.

Overall objec�ve of the project is to contribute to reduc�on of maternal and newborn mortality through training of competent community midwives and their deployment in rural areas of the targeted provinces. In 2014, AADA managed 4 Community Midwifery Schools. Two schools (one in Pak�ka, and one in Ghazni) are funded by USAID. AADA con�nued trainings for 48 students in Mazar-e-Sharif in two CME schools. One CME school funded by The Johanniter, for Balkh province and the second one was funded through Cordaid for Balkh and Jawzjan provinces. The students will be recruited as community midwives into their respected districts.

Community Health Nursing Educa�on Program (CHNE-P):

The overall objec�ve of this project is to contribute to reduc�on of morbidity and mortality of women and children caused by common / communicable diseases through training of competent female nurses and their deployment in rural areas of Wardak, Logar, Jawzjan and Faryab provinces. Total of 150 female community nurses will be trained through these projects. The project is for 28 months, started on May 15, 2013 and will be ended on Sep15, 2015. These projects are funded by Global Fund.

Our Projects Our Projects

Health worker visi�ng Injec�ng Drug Users in outreach site

Gradua�on ceremony of CME students

Lab skills trainings- CHNE School7 8

Support to Midwifery program in Mazar-e-Sharif Ins�tute of Health Sciences (I.H.S):

AADA in partnership with The Johanniter supports the midwifery program of Balkh I.H.S for 70 students for two years period. The project started in July 2014 and will be ended by August 2016.

Mir Bacha Kot 20 Beds Maternity Hospital:

Based on the MOPH request, The Johanniter, in partnerships with AADA, secured fund from the BMZ with 25% co- financing by The Johanniter itself. The project has been approved on November, 2012 for 2 years (from Nov 01, 2012 – Oct 31, 2014 with the total es�mated budget of 1,018,929 Euros. The proposed project aimed to provide lifesaving maternity healthcare services to women of the 7 districts in north of Kabul province i.e. Farza, Guldara, Istalif, Kalakan, Mir Bacha Kot, Qarabagh and Shakardara with more than 300,000 popula�on. During the project period, Mir Bach Kot Hospital ( MBKH) provided quality health service for 55,789 (women and children) including ANC, PNC, family planning and counseling, delivery, Caesarian Sec�on, laboratory tests, OPD for children less than 5, vaccina�on, newborns care, and other reproduc�ve services such as infer�lity, Sexual Transmi�ed Diseases etc.

The u�liza�on of the hospital was gradually increased from 330 up to 4200 clients/month which is a great achievement and shows sa�sfac�on of the community from quality of services offered by MBKH. This project was officially handed over to MOPH on Oct, 30, 2014.

EPI ini�al training for vaccinators:

AADA in partnership with MMRCA conducted 3 months ini�al EPI training for 158 vaccinators from 18 provinces of Afghanistan. This project started in March 2014. AADA/MMRCA conducted the trainings in regional provinces of Afghanistan and provided hostel for trainees. The eligible candidates as vaccinators were selected from remote districts of 18 provinces. A�er 3 months theore�cal and prac�cal course, the students were cer�fied as vaccinators by MOPH. Trained vaccinators were deployed in to the health facili�es in their own districts.

Integrated Management of Acute Malnutri�on (IMAM) and Supplementary Feeding Program

In Nangarhar province, AADA in partnership with Save the Children Interna�onal (SCI) implements this nutri�on project in 35 BPHS health facili�es. Through this project AADA has established 34 Outpa�ent Therapeu�c Program (OTP) sites and one Stabiliza�on Center. 379 CHWs and 88 HFs staff are trained on IMAM guideline. A total of 34 breas�eeding corners are established to promote op�mal IYCF prac�ces among care givers of under five children. Sum of 4,906 under five children are screened for malnutri�on and have go�en treatment for SAM in OTPs. IYCF counseling was provided for 37, 155 mothers.

AADA implements this project in 7 districts of Bamyan province in partnership with Save the Children Interna�onal since July 2013. During 2014, totally 60 OTPs and 3 stabiliza�on centers are established in seven district (Waras, Panjab, Shibar, Kahmard, Saighan Bamyan and Yakawlang) of Bamyan. Furthermore 30 breas�eeding corners established in men�oned districts of Bamyan province.

In 2014 3,920 pregnant/lacta�ng women and 2,040 malnourished children in Bamyan province, and 20,193 pregnant/lacta�ng women and 13,924 malnourished children in Samgan province benefited Supplementary Feeding Programs.ng women and 13,924 malnourished children in Samgan province benefited Supplementary Feeding Programs.

Our Projects Our Projects

Technical staff of Mirbacha kot Maternity Hospital. Health worker assessing a child for malnutri�on9 10

Financial Summary Testimonials

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